what is a leaky gut?

What is Leaky Gut, and How Do You Know If You Have It?

If I’m being honest, I really wish they called it something else.  “Leaky gut” just sounds so gross… and the condition itself is unpleasant enough! But like millions of others, if you’ve made it to this post, you must also be wondering – what IS leaky gut?! Does it even exist?

(While many gastrointestinal doctors and dietitians will insist that leaky gut doesn’t exist, I’ll politely agree to disagree.)

In this article we’ll unpack answers to questons you didn’t even know you had about leaky gut.  I’ll also share some details and insights from my personal healing journey. Buckle up!

This article was edited/updated most recently on July 12, 2022 and has been medically reviewed by Dr. Omar Akhter, MD.

My journey with healing from leaky gut

I was actually mortified when I first started connecting my digestive and autoimmune symptoms to “leaky gut” after Googling them back in 2009.  At that time, most health practitioners weren’t acknowledging leaky gut to be anything more than a theory – but I knew deep in my core that everything had to be connected somehow.

As a new clinician at the time, I chose to keep any and all leaky gut investigations and findings to myself for many years out of fear of being judged/criticized by my colleagues and co-workers.

I had taken all the mainstream advice and went through the motions as directed.  Invasive endoscopes, Lactaid pills, Prilosec, Zantac, Tums, Gas-Ex, probiotics (which were somewhat helpful) and even restrictive elimination diets (out of desperation).

But still, I knew deep down I was going to eventually need to address leaky gut head-on, from a holistic nutritoin standpoint. With all do respect, those symptom-management interventions were just not cutting it – and I was getting worse.

After un-turning lots of rocks and stones over the years and training in functional nutrition, I was eventually able to find enough holistic-minded practitioners and like-minded peers who knew a lot about leaky gut, validated everything I was going through, and helped support me down the path to recovery! Working with a holistic nutritionist early on (while already being a clinical dietitian) was by far the biggest game-changer for me.

Fast-forward to now (2021):

  • I’m no longer suffering from an esophageal web, eosinophilic esophagitis, IBS, lactose intolerance or leaky gut.
  • I have close to 20 less food and environmental histamine-mediated allergies than I did in 2013-2014 based on skin testing and blood work before-and-after.
  • I get to eat a lot more foods than I used to without reacting in my throat or stomach!
    • Disclaimer:  Although my diet is much more flexible now than it was, I’m still extremely conscious and mindful of how I live and what I put in my body. I live holistically, unconditionally.  I don’t eat what most would consider “normal” and I don’t follow a Standard American Diet because that didn’t and still doesn’t work for me.  But I feel younger, more vibrant and more energized now than I did 10 years ago so it’s a huge return on investment! 

I count my lucky stars and realize now all of that happened FOR me, not TO me. I love the person I’ve become in spite of going through all that and finding my way out of it through a path less traveled.

Now, without further ado, let’s answer your burning question…

What IS leaky gut?

Although we’re all supposed to have a semi-permeable gut lining which allows us to absorb nutrients from food, our gut lining is also meant to serve as a barrier between our internal body (blood and internal organs) and the outside world.

“Leaky gut” is NOT a medical diagnosis!  It’s a term used to describe a damaged gut lining.

A leaky (overly permeable) gut happens when the cells that collectively make up the gut lining weaken, causing the “tight junctions” between the cells to open up, thus creating more space for unwanted substances or particles that don’t belong in the body to “leak” into the blood (1, 2).

  • A few common examples of unwanted substances “leaking” into the body through the gut could be pesticide residues from food, pathogenic microbes (such as candida overgrowth which is very common), poorly digested food particles, metals or plastics from food containers, antibiotics from livestock products, etc.

Essentially, people with this “leaky gut syndrome” have a gut with poor boundaries. Too much stuff is getting allowed into the body, when it should really have stayed out and gotten eliminated.  (Poor boundaries – yup, you heard that right!  Lots more to say about boundaries and gut health, but that’s a conversation for another time.)

It’s also important to note: when something is inside our gut, it isn’t yet inside the body!  Your gut lining is kind of like the hole in the middle of a donut not being part of the donut.

(As a quick FYI, the gut starts in the mouth and esophagus and goes all the way down into the stomach, intestines, colon and rectum.  Each of us adults has enough gut tissue to cover approximately a tennis court!)

Signs and symptoms of leaky gut

Leaky gut can manifest with or without digestive ailments.

Unwanted substances and particles entering the bloodstream through a damaged gut lining will begin to wreak havoc over time if left un-checked, and will show up differently for everyone.

Some of the most common symptoms of leaky gut include a combination or spectrum of any of the following:  fatigue/brain fog, multiple nutritional deficiencies, environmental allergies, adverse food reactions, hormonal imbalance (such as PCOS or diabetes), autoimmune conditions, thyroid abnormalities, acne, asthma, and/or even a broad range of psychiatric conditions such as depression/anxiety/ADHD/autism, Alzheimer’s, and more (1, 2, 3, 4, 5, 6).

What causes leaky gut?

We require healthy bacteria to support a healthy mucosal membrane in the gut, so usually leaky gut will typically go hand-in-hand with dysbiosis (an imbalance of beneficial/healthy flora vs pathogenic bacteria/fungus in our gut) (2).

Although leaky gut can be considered an underlying root cause in many health conditions, leaky gut is usually ALSO a symptom or side-effect (much like a domino chain of events) from one or more other underlying conditions such as:

  • Celiac disease/non-celiac gluten sensitivity, candida overgrowth, small intestinal bacterial overgrowth (SIBO), foodborne illness/infections in the gut, food sensitivities (a chicken-or-the-egg situation), stress/trauma, alcohol/drug abuse, an eating disorder, or a laundry list of medications which either disrupt the gut flora/ “microbiome” or cause direct damage to the gut lining itself (that’s a conversation for another time!).
  • Leaky gut is also associated with micronutrient (vitamin and mineral) deficiencies such as vitamin A, vitamin D, and zinc (5); however we can’t always determine which came first. Leaky gut and nutritional deficiencies also seem to exacerbate each other, making both worse off.

Can you test for leaky gut?

Yes!  The most popular test available for testing leaky gut would be an Intestinal Permeability Assessment by Genova Diagnostics (which measures the absorption of lactulose and mannitol in the gut over a period of time).

However, these particles are not considered very large and so it can be difficult to assess what degree of damage there is for people with larger space between their tight junctions.  This test is also expensive and not pleasant to do (some might say a poor “user experience).

A few other testing options to measure gut permeability include a serum zonulin blood test (high zonulin indicates/implies there may be damage to the gut) and zonulin antibody tests which may be more accurate, since zonulin is more of a snapshot in time and it doesn’t stay in the blood for long after it has been released by the gut (7).

Should you test for leaky gut?

While I’m all about testing versus guessing, I never tested for leaky gut on my journey, nor do I recommend this for my clients.  A leaky gut test is more of a formality, in that it won’t really change or impact the direction to take with a gut-healing protocol in any way.  Not to mention, those tests are pretty darn pricey!

Most people choose not to test for leaky gut and instead address underlying implications (such as a root-cause approach, paired with diet/lifestyle and stress management).

What about other clinical and functional medicine tests?

While I’m not an advocate for leaky gut testing, running tests is still a huge component of part 1 of my 6-part signature framework which I refer to as the Complete Gut Repair Roadmap.  (If we aren’t clear on what is going on and how it happened, we can’t take informed action to heal from the root-cause level.)

There are many other types of functional medicine / functional nutrition tests which can be more constructive beyond confirming whether or not you have leaky gut!

The best test(s) for you will vary, depending on many factors.

Clinical testing

Clinical gut health tests should be run through your primary care doctor and gastrointestinal (GI) doctor, to rule out any potential underlying medical conditions.

The biggest challenge here is knowing what to ask for, since most of the time they won’t go out of their way to order the right tests for you.  We must be our own advocates!

Functional nutrition testing

Unlike clinical gut health tests which are meant to identify medical conditions, functional nutrition tests are more sensitive in that they can detect sub-clinical imbalances before they spiral into bigger problems.

While there are dozens of different types of functional nutrition tests out there, a few of the most common tests I run in my clinic include the GI MAP test (to assess the gut microbiome and other aspects of gut health), and mediator release testing to address food sensitivities, only if necessary.

  • Tip:  While many functional medicine practitioners may be able to order you the MRT test, I recommend working with a certified LEAP therapist!

Can you heal if you have a leaky gut?

I’ve been able to heal myself and reverse the majority of my health issues that stemmed from leaky gut first-hand through a combination of diet, lifestyle, herbs and energy medicine.  My committed clients have also been able to heal their gut with great success.

As a functional dietitian nutritionist, LEAP therapist, clinical heralist, and energy healing practitioner I’ve also been able to help hundreds of others to restore their gut health and balance their hormones/immune system using a very holistic, multi-dimensional approach.

It’s not easy, there’s no “quick fix” and healing of any kind does not happen over night- but most importantly, it can be done!

How long does it take to heal your gut?

The amount of time it takes to heal your gut will depend on the level of commitment and consistency you have.

Based on first-hand experience and observation, while people can often start feeling significantly better as soon as a few weeks into their journey, I find healing a leaky gut can usually take anywhere from 6 months to a few years or longer.

It will depend on where you’re at from a clinical standpoint when you start addressing it, your genetics, how old you are, what caused your leaky gut, how long you’ve had it, what else is going on with your health/lifestyle/diet/stress, and how consistent you can remain once you’ve “cracked the code”.

  • Keep in mind: there is no “One Size Fits All” approach when it comes to healing your gut!  If you’re on this journey, the path is not linear and it requires a customized, holistic, multi-dimensional approach that takes TIME!  Everyone’s timeline is different.

If you’d like some extra guidance and support on your journey, I invite you to join us in the next round of the Complete Gut Repair Roadmap group program where I’ll help you to crack your Gut Code™ and start healing from the inside out!

Complete Gut Repair Roadmap with Jenna Volpe - Learn More

References:

  1. Camilleri, Michael. “Leaky gut: mechanisms, measurement and clinical implications in humans.” Gut 68,8 (2019): 1516-1526. doi:10.1136/gutjnl-2019-318427
  2. König, Julia et al. “Human Intestinal Barrier Function in Health and Disease.” Clinical and translational gastroenterology vol. 7,10 e196. 20 Oct. 2016, doi:10.1038/ctg.2016.54
  3. Fasano, Alessio. “All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases.” F1000Research vol. 9 F1000 Faculty Rev-69. 31 Jan. 2020, doi:10.12688/f1000research.20510.1
  4. Obrenovich, Mark E M. “Leaky Gut, Leaky Brain?.” Microorganisms 6,4 107. 18 Oct. 2018, doi:10.3390/microorganisms6040107
  5. Bischoff, Stephan C et al. “Intestinal permeability–a new target for disease prevention and therapy.” BMC gastroenterology 14 189. 18 Nov. 2014, doi:10.1186/s12876-014-0189-7 
  6. Paray BA, Albeshr MF, Jan AT, Rather IA. Leaky Gut and Autoimmunity: An Intricate Balance in Individuals Health and the Diseased State. International Journal of Molecular Sciences. 2020; 21(24):9770. https://doi.org/10.3390/ijms21249770
  7. Vojdani, Aristo et al. “Fluctuation of zonulin levels in blood vsstability of antibodies.” World journal of gastroenterology 23,31 (2017): 5669-5679. doi:10.3748/wjg.v23.i31.5669